Rodriguez-Diaz Rayner, Caicedo Alejandro
Diabetes Research Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA; Rolf Luft Research Center for Diabetes & Endocrinology, Karolinska Institutet, Stockholm, SE-17177, Sweden; Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
Diabetes Research Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA; Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL 33136, USA; Department of Physiology and Biophysics, Miller School of Medicine, University of Miami, Miami, FL 33136, USA; Program in Neuroscience, Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
Best Pract Res Clin Endocrinol Metab. 2014 Oct;28(5):745-56. doi: 10.1016/j.beem.2014.05.002. Epub 2014 May 20.
The autonomic nervous system affects glucose metabolism partly through its connection to the pancreatic islet. Since its discovery by Paul Langerhans, the precise innervation patterns of the islet has remained elusive, mainly because of technical limitations. Using 3-dimensional reconstructions of axonal terminal fields, recent studies have determined the innervation patterns of mouse and human islets. In contrast to the mouse islet, endocrine cells within the human islet are sparsely contacted by autonomic axons. Instead, the invading sympathetic axons preferentially innervate smooth muscle cells of blood vessels. This innervation pattern suggests that, rather than acting directly on endocrine cells, sympathetic nerves may control hormone secretion by modulating blood flow in human islets. In addition to autonomic efferent axons, islets also receive sensory innervation. These axons transmit sensory information to the brain but also have the ability to locally release neuroactive substances that have been suggested to promote diabetes pathogenesis. We discuss recent findings on islet innervation, the connections of the islet with the brain, and the role islet innervation plays during the progression of diabetes.
自主神经系统部分通过与胰岛的连接来影响葡萄糖代谢。自保罗·朗格汉斯发现胰岛以来，胰岛精确的神经支配模式一直难以确定，主要是由于技术限制。利用轴突终末场的三维重建，最近的研究已经确定了小鼠和人类胰岛的神经支配模式。与小鼠胰岛不同，人类胰岛内的内分泌细胞仅被自主神经轴突稀疏地接触。相反，侵入的交感神经轴突优先支配血管的平滑肌细胞。这种神经支配模式表明，交感神经可能不是直接作用于内分泌细胞，而是通过调节人类胰岛的血流来控制激素分泌。除了自主传出轴突外，胰岛还接受感觉神经支配。这些轴突将感觉信息传递到大脑，但也有能力在局部释放被认为会促进糖尿病发病机制的神经活性物质。我们讨论了关于胰岛神经支配、胰岛与大脑的连接以及胰岛神经支配在糖尿病进展过程中所起作用的最新研究发现。
